Accountable Care Organizations
CMS is moving fast to implement physician-hospital partnerships that will operate in the Medicare fee-for-service environment and share in upside savings if they reduce costs and improve quality. MedHOK provides an end-to-end solution for ACOs – software, technology infrastructure and comprehensive consulting services – to help establish a solid foundation and ensure long-term success.
MedHOK’s software can help ACOs build the quality and analytical infrastructure it needs. Our care management modules facilitate the tracking necessary to improve outcomes across the continuum of care. Access to this information by all ACO participants is essential to your success in providing coordinated, integrated care to your members, meeting quality metrics and reducing costs. We can also help with workflow management—especially related to disease and case management, appeals and grievances, care transitions, and test results and referral tracking. These processes will be vital to managing patient care, improving health outcomes and reducing expenditures.
Key Benefits for ACOs:
MedHOK is a complete technology solution for ACOs. The software platform clinically integrates participant information in real-time between providers and hospitals within the ACO to provide participants with high-quality, cost-effective care. The disease and case management modules allow the ACO to manage care for high-risk patients, reducing unnecessary utilization and encouraging better patient self-management. Disease and case management are central to assisting ACOs with meeting quality metrics and reducing Medicare expenditures in order to recognize shared savings. ACOs can monitor its quality performance in real time to ensure the organization is on target to meet the rigorous quality standards that will allow a share in any reductions in Medicare FFS expenditures.
MedHOK offers comprehensive services that establish a solid foundation to help ensure the long-term success of your ACO including:
- Assessment of operational, financial, clinical, quality, IT and claims infrastructure
- Enhancement of organizational, operational, clinical and quality infrastructures to ensure doctors and hospitals have the right information to serve ACO members
- Drafting comprehensive business plans, including the needed legal entities and relationships for the ACO
- Preparing for expected NCQA certification
- Facilitating contracting and structuring financial relationships between doctors and hospitals
- Undertaking financial modeling to clearly define challenges and opportunities
- Preparing the formal CMS application to secure ACO designation
- Ongoing assessment of current and future CMS regulations governing ACO development and operation
Want to Know More?
Complete the form and let us know how we can help you utilize the power of MedHOK’s enterprise compliance software to manage Risk, Care, and Quality.